What is the PRSP?

1. Mainstreaming MDGs & HIV/AIDS into National Development Instruments and PRSPsVladimir Mikhalev,UNDP Bratislava Regional CenterRESPONDING TO HIV/AIDS IN EUROPE AND THE CIS4th RBEC Community of Practice MeetingMoscow, 5-7 June 2007

2. What is the PRSP? • PRSPs emerged from 1999 as a result of WB & IMF initiative intended to improve development outcomes • PRSP is a short-term national policy framework comprising key development objectives and policy tools aimed at poverty reduction • PRSPs operationalise long-term objectives such as MDGs by specifying concrete public policies and expenditure priorities • Serve as a framework for all external assistance geared towards poverty reduction

3. PRSPsunderlying principles • County-driven, involving broad-based participation • Comprehensive in recognizing the multi-dimensional nature of poverty • Result-oriented and focused on outcomes that benefit the poor • Partnership-oriented involving coordinated participation of development partners • Based on long-term perspective for poverty reduction

4. IFIs support to PRSPs • PRSPs introduced a new way of providing assistance to low income countries by WB & IMF • Low income countries were required to develop PRSPs in order to get access to concessional resources and debt relief under HIPC programme • IMF aligned support to PRSP through PRGF as the main lending instrument • WB introduced PRSC to support PRSPs

5. PRSPs / PRSs in EECA region • PRSP countries that rely heavily on IFI financing: • Tajikistan, Kyrgyzstan, Armenia, Azerbaijan, Georgia, Moldova, Albania, Serbia & Montenegro, Bosnia-Herzegovina • Other countries having PRS but not linked to IFI funding: • Uzbekistan, Kazakhstan, Ukraine • No PRSs: • Russia, Belarus, Turkmenistan • New EU member states and EU accessions countries incorporate poverty reduction policy in EU social inclusion agenda

6. PRSP policy components • Macroeconomic programme • including growth projections and key fiscal choices • Pro-poor structural and sectoral polices, • including private sector & SME development, financial and trade liberalisation • Polices for social inclusion and equity: • employment policies, rural development, education, health, social protection • Governance and public sector management • Prioritised and costed action plans in all policy components

7. Strengths of PRSPs • Improved focus on poverty • Based on sound poverty diagnostics • Capture multidimensional income and non-income poverty aspects • Gather sector strategies and expenditure plans under poverty reduction umbrella • Enhanced monitoring systems • Broad participation

8. Weaknesses of PRSPs • Lack of understanding of sources of growth and its social impact • Too broad objectives, lack of vision and operational guidance (road maps) • Weak linkages between growth and poverty reduction, between macroeconomic growth and sectoral policies (e.g. fiscal polices and SME support) • Pro-poor policy choices focus on public expenditures on health, education and other social programmes but lack attention to infrastructure and rural development • Poor costing and prioritisation (wish lists) and weak links to budgetary processes (MTEF) • Imperfect monitoring indicators and lack of data • Limited participation in PRS implementation and monitoring by parliaments, civil society, private sector

9. Poverty reduction outcomes • Poverty in EECA in 1998-2003 decreased • from 20 % to 12 % of the population; 40 million moved out of poverty; poverty did not decreased in Georgia, Poland & Lithuania • Inequality declined with the exception of Georgia and Tajikistan • Mixed progress on non-income poverty: • improvements in education, but in Western Balkans, Tajikistan & Kyrgyzstan enrolment declined; • HIV and TB spread in many countries, high infant mortality and increased maternal mortality in Central Asia and Caucasus, • poor access to safe water in lower income countries • Growth failed to generate enough jobs • Growth in low income counties did not increase productivity in agriculture and small trade; incomes of large sections of workforce employed there did not increased • Regional inequalities increased – gap between capital cities and rural areas & small towns

10. Policy challenges • The projected rates of growth are insufficient to achieve MDG poverty reduction targets by 2015 • higher rates of growth are needed • growth needs to be more pro-poor • Core policy areas are employment generation and private sector development • Non–income MDGs, especially in health are unlikely to be met • public investment needs to be strengthened to improve social infrastructure and services

11. What is needed in new PRSPs • Build on the good experience of the previous PRSP • Incorporate MDGs and focus on particular aspects of human poverty: quality of education and skills, health, gender, water and sanitation • Focus on regions and tailor made for specific regional needs • Broad participation of development partners • Result-orientation and focus on outcomes • Robust monitoring and evaluation system

12. Mainstreaming MDGs into PRSPs • PRPS have direct references to MDGs • Armenia, Azerbaijan, Moldova, Tajikistan and Kyrgyzstan explicitly establish relationship between PRSP & MDGs and targets • Armenia PRSP have special tables linking PRSP to MDG targets and indicators • Tajik PRSP establishes 2015 as target year and MDG targets as PRSP targets • PRSPs plan increased resource flow to MDG sectors: job creation, micro financing, education, health, environment • Despite increase in funding it is not sufficient for MDG achievement • PRSP & MDG monitoring is aligned • Time consistency • PRSPs are mid-term 3-5 year strategies, targets are aligned with 2015 MDGs based on assumption of linear progress • Armenia PRSP are long-term having 2015 time horizon

13. Prominence of HIV/AIDS in PRSPs The new Welfare Improvement Strategy in Uzbekistan • Acknowledges HIV/AIDS epidemic as the fastest growing in the region • Key groups at risk: intravenous drug users and prison population (but no mention of sex workers and men having sex with men) • Increasing transmission of HIV from mother to child National goal: halting and beginning to reverse the spread of HIV/AIDS by 2015

14. Measures combating HIV/AIDS • Preventive measures focused on groups at risk • Create conducive legal environment to work with high risk groups • Increased availability of voluntary testing • Counselling • Building capacity of health professionals • Involvement of civil society • Better access to medical care for those infected • Availability of antiretroviral treatment, especially for pregnant women and children • Supportive environment for and protection of the rights of people living with HIV / AIDS • Targeted safety nets

15. Key problems: costing and funding • Experience of Tajikistan • Costing model developed for UNAIDS by Futures Group • Estimates are highly speculative • No funds available for HIV / AIDS in the health budget other than at the expense of other interventions • Financing gap amounts to almost all HIV / AIDS costing and is likely to go uncovered without external assistance • Lack of sufficient detail on HIV/AIDS in PRSPs; need for link to health SWAPs / health care reform programmes

16. Tajikistan: Financial Estimations for combating HIV/AIDS, 2005-2015 (US$ million)Source: MDG Needs Assessment, Republican Centre on AIDS Prevention and Control of the MoH, 2005

17. HIV /AIDS costing methods • Cost estimates depend on • Pace of epidemic expansion • Price of drug therapies • Range of care and treatment offered • Assumptions in the resource model for Tajikistan • Adult prevalence rate rises to 5.4 by 2010 and remains constant thereafter • Annual 10-per cent reduction in the cost of palliative therapies • Peer education for 20 percent of the labour force each year • Unit costs of interventions based on regional average in some cases adjusted to Tajikistan’s specifics